title: An increase in exhaled CO concentration in systemic inflammation/sepsis.
abstract: Despite recent progress in Critical Care Medicine, sepsis is still a major medical problem with a high rate of mortality and morbidity especially in intensive care units. Oxidative stress induced by inflammation associated with sepsis causes degradation of heme protein, increases microsomal free heme content, promotes further oxidative stress and results in cellular and organ damage. Heme-oxygenase-1 (HO-1) is a rate-limiting enzyme for heme breakdown. HO-1 breaks down heme to yield CO, iron and biliverdin. Measurement of CO in exhaled air may potentially be useful in monitoring changes in HO enzyme activity in vivo, which might reflect the degree of inflammation or oxidative stress in patients with systemic inflammation. The increased exhaled CO concentrations were observed after anesthesia/surgery, in critically ill patients and also in systemic inflammation/sepsis. Some reports also showed that exhaled CO concentration is related to mortality. Further studies are needed to elucidate whether increased endogenous CO production may predict a patient's morbidity and mortality. Techniques for monitoring CO are continuously being refined and this technique may find its way into the office of clinicians.
authors.affiliation: Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1, Shikatacho, Kita-ku, Okayama 700-8558, Japan. morimatu@ms7.megaegg.ne.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morimatsu
authors.forename: Toru
authors.initials: T
authors.lastname: Takahashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsusaki
authors.forename: Masao
authors.initials: M
authors.lastname: Hayashi
authors.forename: Jyunya
authors.initials: J
authors.lastname: Matsumi
authors.forename: Hiroko
authors.initials: H
authors.lastname: Shimizu
authors.forename: Masaki
authors.initials: M
authors.lastname: Matsumi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Morita
mesh_terms: D000758:Anesthesia; D015415:Biomarkers / Q000378:metabolism; D001944:Breath Tests; D002248:Carbon Monoxide / Q000378:metabolism*; D016638:Critical Illness; D045853:Exhalation; D051547:Heme Oxygenase-1 / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D011184:Postoperative Period; D018805:Sepsis / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D002248:Carbon Monoxide; D051547:Heme Oxygenase-1